Strengths and Limitations
An acknowledged strength of this study is that the PRISMA statement was adhered to and a comprehensive literature search according to the AMSTAR criteria conducted. A large scope of evidence was available and retrieved from Embase, Medline and the Cochrane Database of Systematic Reviews. An identified limitation is that the review authors who assessed the quality of the studies were aware of the journal of publication and authorship of the study. However, the potential for bias was minimized by having two independent review authors reach a consensus for each AMSTAR criteria. Another limitation involves the relatively small sample size of included studies (n=48). With a greater number of studies published in this area of research, new trends regarding methodological quality and publication details may emerge. Furthermore, the comparison between AMSTAR score and the number of citations may be affected by publication date of the systematic review; those recently published will not have accrued as many citations as older publications, even though they may have higher AMSTAR scores. However, we have chosen to utilize this metric as it may provide insight to how the methodological quality of the publication has affected current policymaking.